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For more information please feel free to contact Mr Ramakrishnan's office:

Tel: 01245 463439

Fax: 01245 461569

Email: plasticsurgery@ramakrishnan.co.uk

or fill in the form on the right

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Request a call back
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Providing expert care
in Reconstructive and
Cosmetic Surgery

Face

Why do patients request a brow lift?
With the passage of time the ligaments that anchor the skin of the forehead stretch resulting in descent of the brow. This results in a lowering of the eyebrows and the appearance of folds of skin on the upper eyelid. Patients say that they attract unwelcome comments about being tired or worried from acquaintances and colleagues at work and are unhappy about the frown lines on the forehead and between the eyebrows. This is often a cause of significant distress and results in a request for a consultation to discuss rejuvenation of the upper half of the face.

Are there any reasons for a patient not to have a brow lift?
Patients who are actively smoking or on blood thinning medication such as aspirin or warfarin have a higher risk for postoperative complications such as bleeding, wound infections and delayed wound healing. It is advisable not to consume nicotine in any form for at least two weeks before this procedure and at least two to three weeks after. Medication such as aspirin or warfarin may need to be stopped if they are not absolutely essential at the appropriate time before surgery. This should be discussed with your Consultant or GP.

What does surgery involve?
The procedure is carried out under general anaesthesia and usually involves an overnight stay in hospital. It can be carried out endoscopically, www.coaptsystems.com ie with the help of a telescope through a small incision inside the hairline which heals well and is not very visible after a few weeks, or it can be carried out as an open procedure within an incision across the hairline in a hidden part of the scalp. The incisions are sutured and quite often a head bandage is applied for the first couple of days after surgery. Patients are discharged home the following day and are able to wash and shampoo their hair as normal. Sutures are removed a week after surgery.

What is the normal postoperative course?
Most patients experience significant bruising and swelling of the forehead and may have a black eye, which normally resolves in about a week. The eyebrows may appear excessively elevated for a few days after surgery but they descend to a more natural position within a period of a couple of weeks.

How much time do I need off work?
Most patients are able to return to work a couple of weeks after the procedure.

What are the potential complications for this procedure?
Like any other surgical procedure brow lift has complications such as bleeding, haematoma (blood clot under the skin), infection, visible scars and asymmetry. There can be a small amount of hair loss on either side of the scar but this hair normally grows back after six to twelve months. The scars can be visible especially in men as the hair line recedes. Very rarely the nerve that supplies the forehead muscle which lifts the eyebrow may be stretched or damaged in this procedure and can result in an inability to raise the eyebrows.

Facts at a glance

Surgery time 2 hours
Hospital stay 1 night
Anaesthetic assessment Possibly
Pre admission tests Yes
Reasonably mobile 1-4 days complete rest.
Washing 1 day
Driving 2 weeks
Sport & exercise including gym 4 weeks
Full recovery 6-8 weeks
Time off work 1-2 weeks
Bras and garments No
Long term issues Some numbness over the scalp
Blepharoplasty is one of the most popular surgical procedures. It is a procedure to remove excess skin, along with fat and muscle, from the upper and lower eyelids. Eyelid surgery can lift drooping upper lids and reduce the puffy bags that form below your eyes.

What does the surgery involve?
For the upper eyelids the incision is made in the natural crease line that occurs 1 cm above the eyelashes. The incisions might extend into the crow’s feet or laughter lines at the outer corners of your eyes. Working through the incisions your surgeon will separate the skin from the subcutaneous layers and remove excess fat and trim sagging muscle and skin. The incisions will then be closed with very fine sutures.

For the lower eyelids the incision starts underneath the eyelashes and extends 1cm or so outwards into the crow’s feet area, the skin is then lifted upwards and outwards, gently tensioning the area and the overlapping skin removed. Again the incisions will then be closed with very fine sutures.

Are there any reasons for a patient not to have this procedure?
Patients who are actively smoking or on blood thinning medication such as aspirin or warfarin have a higher risk for postoperative complications such as bleeding, wound infections and delayed wound healing. It is advisable not to consume nicotine in any form for at least two weeks before these procedures and at least two to three weeks after. Medication such as aspirin or warfarin may need to be stopped if they are not absolutely essential at the appropriate time before surgery. This should be discussed with your Consultant or GP.

What will happen in the recovery period?
After surgery you may have lubricating ointment on your eyes and maybe a bandage. Some bruising and swelling will be experienced during the first and second weeks, however the majority of the swelling usually subsides after the first 10 days. Your eyes may feel dry at first but eye drops can help with this. Any sutures are usually removed after 5 – 7 days. Scars will form as a result of the surgery. Overall these scars heal relatively well but will differ in each individual patient.

What is the recovery time?
Recovery varies from patient to patient and it is advisable to take it easy for the first week after surgery. Most people are ready to go out and return to work after a week to 10 days. You should keep your activities to a minimum for three to five days and avoid more strenuous activities for about three weeks.

What are the risks?
All surgery carries some uncertainty and risk, but complications are infrequent and minor. You can reduce the risks by closely following your surgeon’s instructions both before and after surgery. You should make known any thyroid disease, high blood pressure, diabetes or eye disorder such as detached retina or glaucoma.
Occasionally a pool of blood can collect under the skin after the operation (haematoma) this usually disperses spontaneously over two or three weeks. Quite commonly the margin of the lower lid is slightly pulled away from the eye during the first day or two after surgery due to swelling. This will settle on its own or with the help of steri strips. Some times tiny white cysts can appear along the stitch line.

Before and After

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Video

Facts at a glance

Surgery time 1-1 1/2 hours
Hospital stay Day case
Anaesthetic assessment Possibly
Pre admission tests Yes
Reasonably mobile Avoid strenuous activities for 7-10 days
Washing 1 day
Driving 2 weeks
Sport & exercise including gym 4 weeks
Full recovery 8-10 weeks
Time off work 1-2 weeks
Bras and garments No
Long term issues Watering of the eyes for 1-2 weeks at times

Click here to download the Patient Post Op Care Sheet for Blepharoplasty

Why do patients request a facelift?
With the passage of time the ligaments that hold the skin of the face in position stretch and there is also a decrease in the natural fat that is present in the tissues. As a result of this the skin on the face, the brow and the neck begins to sag. Patients do not like the appearance of jowls, deep creases in the cheeks, wrinkles and bands in the neck as these are recognisable signs of ageing. This is a common reason for consultations for facelifts and neck lifts.

Are there any reasons for a patient to not have a facelift?
Patients who are actively smoking or on blood thinning medication such as aspirin and warfarin are at a high risk of complications such as bleeding or wound infections and delayed wound healing. It is advisable to not consume nicotine in any form for six weeks before a facelift and a similar time after. Medication such as aspirin or warfarin may need to be stopped (if this is not for an essential or life-threatening condition) at the appropriate time before surgery. This should be discussed with your Consultant or GP.

What does a facelift involve?
A facelift or neck lift is carried out under general anaesthesia and involves one or two nights in hospital. Following the operation there is a large padded bandage around the neck and face along with a tube drain underneath the skin to remove any blood or fluid that may collect following surgery. The drain is normally removed the day after surgery and so is the dressing around the face and neck. Patients are usually able to shower before discharge from hospital with fresh dressings and an elasticated support for the neck and cheeks. An outpatient appointment is arranged for a few days after surgery for removal of sutures.

How long does bruising and swelling last following the operation?
Bruising and swelling following surgery normally resolves within ten to fourteen days after the operation.

How much time do I need off work?
Most patients are able to return to work and to social activities within two to three weeks of their operation.

How long does the effect of a facelift last?
The effects of a facelift can last up to five to ten years following surgery. A facelift does not stop the process of ageing but can make the effect of the ageing process less obvious.

What are the complications of this procedure?
A small percentage of patients undergoing a facelift can have complications just like any other surgical procedure which include bleeding, haematoma (blood clot under the skin), infection, delayed healing of the wound, asymmetry and scars which are visible in the early post-operative stage but which normally fade over a period of months. There can also be a loss of function or inju